The recent article by Aly et al provided for highly stimulating and interesting reading.1 Elevated serum leptin in patients with psoriasis may contribute to the development and progression of a number of comorbidities.
For instance, G-2548A polymorphism of the leptin gene is associated with accentuated risk of developing symptomatic psoriasis.2 This is secondary to elevated leptin levels. A positive association exists between serum interleukin 6 levels and serum leptin levels. Patients with underlying psoriasis also exhibit increased carotid intima-media thickness secondary to elevated leptin levels.3 Thus, psoriasis is a risk factor for atherosclerosis and contributes to the progression of diseases such as coronary artery disease.
Elevated leptin levels are also associated with an increased risk of developing psoriatic arthritis. Individuals with obesity and excessive adipose tissue and underlying psoriasis are therefore at an increased risk of developing arthritis. Individuals with psoriatic arthritis demonstrate lower adiponectin levels.4 A similar negative association exists between serum chemerin levels and psoriatic arthritis. Loss of weight is associated with a decline in serum leptin levels. This may contribute to symptom improvement in psoriasis patients, especially in those with concurrent obesity. A direct relationship exists between serum leptin levels and “osteoclast precursors” and “psoriatic arthritis joint activity index.”5
The above examples clearly illustrate that the elevated serum leptin levels seen in psoriatic patients may contribute to and augment a number of comorbidities.
S.K. has no conflicts to disclose.
- Aly DG, Abdallah IY, Hanafy NS, Elsaie ML, Hafiz NA. Elevated serum leptin levels in nonobese patients with psoriasis. J Drugs Dermatol. 2013;12(2):e25-e29.
- Abdel Hay RM, Rashed LA. Association between the leptin gene 2548G/A polymorphism, the plasma leptin and the metabolic syndrome with psoriasis. Exp Dermatol. 2011;20(9):715-719.
- Enany B, El Zohiery AK, Elhilaly R, Badr T. Carotid intima-media thickness and serum leptin in psoriasis. Herz. 2012;37(5):527-533.
- Russolillo A, Iervolino S, Peluso R, et al. Obesity and psoriatic arthritis: from pathogenesis to clinical outcome and management. Rheumatology (Oxford). 2013;52(1):62-67.
- Xue Y, Jiang L, Cheng Q, et al. Adipokines in psoriatic arthritis patients: the correlations with osteoclast precursors and bone erosions. PLoS One. 2012;7(10):e46740.